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Title of Journal: Surg Endosc

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Abbravation: Surgical Endoscopy

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Springer US

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DOI

10.1007/bf00175668

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ISSN

1432-2218

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Laparoscopic surgery for colorectal cancer patient

Authors: Soo Young Lee Chang Hyun Kim Young Jin Kim Hyeong Rok Kim
Publish Date: 2016/04/29
Volume: 30, Issue: 12, Pages: 5472-5480
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Abstract

Laparoscopic colorectal surgery may be impeded by intraperitoneal adhesions caused by previous abdominal surgery The aim of this study was to determine the effect of previous abdominal surgery on short and longterm outcomes of laparoscopic colorectal surgeryWe retrospectively reviewed 3188 patients with primary colorectal cancer who underwent laparoscopic colorectal surgery between January 2004 and December 2013 Patients with a history of abdominal surgery n = 593 186  were compared to those without such history n = 2595 814 Patients who had undergone previous abdominal surgery exhibited acceptable intraoperative outcomes including conversion to open surgery operative time estimated blood loss and the number of harvested lymph nodes Overall postoperative complication rates were similar between the groups 108 vs 106  p = 0885 Subgroup analysis revealed that patients with history of major abdominal surgery n = 165 had higher rates of conversion to open surgery 42 vs 17  p = 0033 prolonged postoperative ileus 55 vs 20  p = 0008 and wound complications 42 vs 12  p = 0006 when compared to those without prior abdominal surgery Previous major abdominal surgery was an independent risk factor for conversion to open surgery adjusted odds ratio = 2740 95  confidence interval CI 1197–6269 Diseasefree survival adjusted hazard ratio HR = 0847 95  CI 0532–1346 and overall survival adjusted HR = 0846 95  CI 0432–1657 were not observed to differ between the previous major abdominal surgery group and those without previous abdominal surgeryLaparoscopic colorectal surgery in patients with a history of abdominal surgery exhibited acceptable short and longterm outcomes Patients with a history of previous abdominal surgery had relatively higher rate of conversion to open surgery as well as higher incidences of prolonged postoperative ileus and wound complications compared to patients without such history

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